Septic Shock
Conditions
Brief summary
Prospective single centre study to assess the feasibility of fluid resuscitation guided by macrocirculatory and microcirculation parameters in patients in the early stages of septic shock. The investigators will utilise a novel point of care tool to assess microcirculatory sublingual perfusion in patients with septic shock. This, in combination with conventional haemodynamic monitoring will determine the timing and volume of resuscitative fluid administration. The feasibility of this technique will be determined prior to embarking on a pilot RCT.
Interventions
DRUGIntra venous fluid
Volume of intra venous fluid administered during GDT protocol
Sponsors
King's College London
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Feasibility study - single arm
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Age \> 18 years Within 6 hours of ICU admission Evidence of suspected or confirmed infection Serial Organ Failure Assessment (SOFA) score increase of 2 or more (assuming baseline 0 if no previous measures) Requiring vasopressor therapy to maintain a MAP \> 65mmHg Lactate \> 2 mmol/l despite initial fluid resuscitation Requirement for advanced haemodynamic monitoring (PiCCO system) in the opinion of the attending clinician
Exclusion criteria
Patients not expected to survive 24 h in whom the intent of treatment is palliative Patients in whom the primary cause of the shock state is cardiogenic \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to acquire POEM score | 6 hours | Feasibility measure of point of care test |
| Effect of POEM score on clinical decision making | 6 hours | Feasibility outcome measure |
Countries
United Kingdom
Contacts
Primary ContactSam Hutchings, PhD
Outcome results
None listed